It’s the stuff bad dreams are made of: you have something important to say, but the words don’t come out. Or, even worse, you’re speaking perfectly clear, but no one can understand you.

Those common themes of bad dreams can become a reality for patients who are deaf, unable to speak due to a medical condition or are simply to scared in a health care setting. Or, on the off chance they speak a particular dialect that interpreter services do not understand, it can create a barrier.

Communication is key to good patient care, so Suzanne Badman, Upstate’s Director of Patient Education and Interpreter Services, and hospital volunteer Mariela Rodriguez-Aguedas, developed a series of picture aids to help patients communicate with their caregivers.

Many of us are familiar with the smiley face to sad face spectrum to illustrate our pain level. While that is part of this, there’s also much more.

A patient can point to a picture to:

-indicate what part of the body hurts

-communicate specific symptoms

-express emotions

-request personal hygiene products

-order a chicken sandwich

-ask for a teddy bear

More than 250 visuals appear on categorized sheets, available to every nurses’ station throughout the Upstate University Hospital campuses and many outpatient locations.

“Visuals have the same meaning across cultures, as images are a very basic human communication tool,” Badman says. “I’ve worked on the floors for 20 years, all over the country and it has always been a dream of mine to find a method of communication have equal meaning among cultures.”

“When we showed these to various nurses groups and senior management, many acknowledged a personal experience where the aids would have come in helpful to solve a patient communication barrier,” she recalls.

Mariela is originally from Costa Rica, lived many years in Germany and now volunteers at Upstate. She speaks Spanish, German and English fluently. She is also a medical interpreter and translator and is preparing to go to nursing school.

Upstate cares for many patients who are refugees or immigrants. Interpreter services are requested about 1,000 times a month for patients at Upstate’s hospitals and medical offices.

With resources such as the interpreter services and the new picture aids, communication barriers will remain simply the stuff of bad dreams — and not the reality of patient care.